Basic Information
| Provider Information | |||||||||
| NPI: | 1295263598 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAVID M. DRANETZ, M.D., P.L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3515 LONGMIRE DRIVE | ||||||||
| Address2: | SUITE B BOX 178 | ||||||||
| City: | COLLEGE STATION | ||||||||
| State: | TX | ||||||||
| PostalCode: | 778455489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082925366 | ||||||||
| FaxNumber: | 8664597478 | ||||||||
| Practice Location | |||||||||
| Address1: | 3322 LONGMIRE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | COLLEGE STATION | ||||||||
| State: | TX | ||||||||
| PostalCode: | 778456088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9792002043 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2017 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | DRANETZ | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5082925366 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | K5906 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.